Outsmarting lateral hip pain

08/06/23

Do you experience persistent hip pain, particularly at night? It turns out you’re not alone. Meet greater trochanteric pain syndrome (GTPS), a common cause of pain on the outside of the hip that affects countless individuals. This blog is your comprehensive guide to greater trochanteric pain syndrome.

Greater trochanteric pain syndrome is a common condition that causes pain and discomfort in the outer region of the hip. It typically affects middle-aged and older individuals, particularly women, but can occur in both sedentary individuals and athletes. GTPS can significantly impact daily activities such as walking, lying on the affected side and sitting. It is primarily caused by irritation of the gluteus medius and minimus tendons (where the muscle attaches to the bone) and/or inflammation of the surrounding bursae (fluid-filled sacs that reduce the friction of the tendon on the bone).

Several factors can contribute to the development of GTPS, including overuse, trauma, and muscle imbalances around the hip. Repetitive hip movements, such as running, climbing stairs, or even prolonged sitting can create strain or compression of the tendon. Direct trauma such as a fall or blow can also trigger GTPS. More often we see a combination of repetitive movements or overuse with muscle imbalances which puts increased stress on the tendon or bursa, leading to pain.

Individuals often experience pain and tenderness typically on the outside of the hip. Sometimes this pain can radiate down the side of the thigh or buttock. Symptoms are generally worse with activity, especially those which involve repetitive movements or compressive positions on the tendon such as walking, running, climbing stairs and prolonged sitting. Some individuals may also experience pain or discomfort at night when lying on the affected side which can make it difficult to find a comfortable position. 

Your osteopath can help diagnose your hip pain with a thorough history and clinical examination. Sometimes investigations such as imaging (ultrasound, X-ray, MRI) may be necessary to rule out other conditions. Treatment of GTPS is aimed at relieving pain, reducing inflammation and managing tendon load. This can be done via manual therapy of the local tissues, activity modification and prescribed exercises to increase the tendon’s ability to tolerate load. Contrary to what you might feel your hip needs, stretching the tendon is typically not recommended as this can actually increase the compressive load on the tendon. 

Consult with your osteopath today to assess your hip pain.

Reference:

1. Grimaldi A, Mellor R, Hodges P, Bennell K, Wajswelner H, Vicenzino B. Gluteal Tendinopathy: A Review of Mechanisms, Assessment and Management. Sports Medicine. 2015;45(8):1107-1119.